Table 1.
Demographic Data and Bone Turnover Marker Levels of Patients With Adrenal Adenomas
| CS (n = 22) | MACS (n = 92) | NFAT (n = 99) | P Value (CS vs MACS vs NFAT) | P Value (MACS vs NFAT) | |
|---|---|---|---|---|---|
| Demographics | |||||
| Age, median (range), years | 41.5 (18-61) | 59.5 (28-82) | 59 (28-93) | <0.0001 | 0.664 |
| Female, n (%) | 18 (86%) | 57 (62%) | 67 (68%) | 0.456 | 0.41 |
| BMI median (range), kg/m2 | 30.1 (21.9 – 54.6) | 31 (17 – 53) | 31 (15 – 51) | 0.06 | 0.525 |
| Weight, median (range), kg | 84 (62-113) | 89 (62-128) | 90 (63-126) | 0.29 | 0.94 |
| Computed tomography imaging | |||||
| Tumor size, median (range), cm | 3 (0.5-6.1) | 3.1 (0.5-14.4) | 1.7 (3-4.5) | <0.0001 | <0.001 |
| Unenhanced CT attenuation, n, median (range) Hounsfield units, n = 151 | n = 13 | n = 68 | n = 70 | 0.416 | 0.32 |
| 10 (-55 to 36) | 8.25 (-20 to 36) | 7 (-27 to 41) | |||
| Endocrine work up | |||||
| Cortisol after overnight 1 mg dexamethasone, median, nmol/L (range), µg/dL (range) | 235 (61-689) | 83 (52-441) | 33 (25-49) | <0.0001 | <0.001 |
| 8.5 (2.2-25) | 3 (1.9-16) | 1.2 (0.9-1.8) | |||
| ACTH, n, median, pmol/L (range), pg/mL (range n = 162 | n = 18 | n = 78 | n = 66 | <0.0001 | <0.0001 |
| 1.1 (1.09-2.94) | 1.97(1.1-6.2) | 3.41 (2.0-6.16) | |||
| 5 (4.99-13.4) | 8.95 (5-28.2) | 15.5 (9.27- 28) | |||
| Urine cortisol, n, median | n = 21 | n = 74 | n = 61 | <0.0001 | 0.049 |
| µg/dL/24h (range) | 108 (25-875) | 26(2.6-84) | 22(3.4-71) | ||
| nmol/24h (range) n = 156 | 298 (69-2415) | 72(7.2-232) | 61(9.4-196) | ||
| DHEA-S index, n, median (range), n = 146 | n = 19 | n = 71 | n = 56 | <0.0001 | 0.007 |
| 0.65 (0.18-7.03) | 2.63 (0.11-17.2) | 4.63 (0.58-16.41) | |||
| Cardiovascular Risk Factors | |||||
| Hypertension, n (%) | 16(73%) | 66(73%) | 63(64%) | 0.36 | 0.17 |
| Dyslipidemia, n (%) | 7(32%) | 57(63%) | 53(54%) | 0.03 | 0.18 |
| Diabetes Mellitus/IFG, n (%) | 9(41%) | 38(41%) | 40(41%) | 0.99 | 0.98 |
| Bone Disease | |||||
| DXA Bone density scans performed, n (%) | 8 (37%) | 48 (52%) | 31 (31%) | ||
| Osteopenia, n (%) | 5 (62%) | 27 (56%) | 16 (52%) | 0.84 | 0.69 |
| Osteoporosis, n (%) | 3 (38%) | 10 (21%) | 6 (19%) | 0.56 | 0.87 |
| Osteopenia and osteoporosis, n (%) | 8 (100%) | 37 (77%) | 22 (71%) | 0.09 | 0.54 |
| Bone Turnover Markers | |||||
| Osteocalcin, mean (SD), (range), ng/mL | 14.8 (16.3) (2.2-79.6) | 20.1 (10.2) (5.4-53.7) | 21.3 (12.1) (2.2-78.8) | <0.0001 | 0.39 |
| PINP, mean (SD), (range), µg/L | 34.8 (23.6) (12.3-91.6) | 48.7 (23.5) (13.3-123) | 48.5 (22) (3-152) | 0.003 | 0.84 |
| CTX, mean (SD), (range), ng/mL | 0.3 (0.2) (0.09-0.93) | 0.4 (0.3) (0.05-1.28) | 0.4 (0.2) (0.10-1.16) | 0.15 | 0.5 |
| Sclerostin, mean (SD), (range), pg/mL | 419 (199) (73.2-683) | 538 (296) (111-873) | 624 (218) (202-1273) | <0.0001 | 0.005 |
All P values < 0.05 were considered statistically significant.
Abbreviations: ACTH, Adrenocorticotrophic hormone; BMI, body mass index; CS, Cushing syndrome; CT, computed tomography; CTX, C-terminal telopeptide of Type 1 collagen; DHEA-S, dehydroepiandrosterone sulfate; DXA, dual-energy x-ray absorptiometry; IFG, impaired fasting glucose; MACS, mild autonomous cortisol secretion; NFAT, nonfunctioning adrenal tumors; PINP, N-terminal propeptide of type 1 collagen; SD, standard deviation.